Financing for HIV/AIDS Prevention, Care and Treatment in Thailand

Abstract

To describe the trend and proportion of key financing sources for HIV/AIDS prevention, treatment, and social support programs in Thailand and to identify facilitators and barriers to effective financial management and strengthen the monitoring system. Based on a comprehensive review of financial reports from various sources such as UNGASS and NASA, we explored the key financing sources for HIV/AIDS prevention, treatment, and social support programs in Thailand. In addition, we conducted in-depth interviews with different key informants responsible for the activities in response to the national policy on HIV/AIDS at provincial and district levels including domestic and international donors to assess the financial management, coordination and monitoring system. The total expenditures on HIV/AIDS in fiscal years 2007, 2008 and 2009 were slightly increasing from 204 million USD in 2007 to 210 and 218 million USD in 2008 & 2009, respectively (Table 1). However, the share of expenditures on HIV/AIDS as percentage of GDP decreased from 2.7% in 2007 to 1.9% in 2008 and 2009. Domestic funding accounted for the majority of the HIV/AIDS program financing but most of the spending was emphasized on care and treatment with a smaller proportion in prevention activities. In fact, most of the preventive programs were contributed by the Global Fund and other international sources. Improvements in effective operational system development in program management, monitoring and evaluation were notably needed. Thailand has shown its attempt to be self-reliant in combating HIV/AIDS. Nevertheless, care and treatment expenditures overshadow prevention, and most of the preventive programs have been financed by international sources. Thus, the dominance of entitlement programs in funding for HIV/AIDS treatment challenges health policy makers to monitor the extent and quality of HIV/AIDS care. For a better efficiency and future cost savings in treatment and care, more investment in prevention programs is essential, especially due to the declining support from international funds.